Updated 10:00 pm, Monday, September 28, 2009

For a 15-year-old, or anybody else, Michael Blankenship had already been through a lot when he arrived at Seattle Children's hospital for some routine dental work.

Autism had left Blankenship unable to speak. The condition complicated simple things, like school or a dental appointment.

What left him dead, though, was the painkiller-laced patch -- meant to ameliorate chronic pain in cancer patients and others -- that was prescribed to Blankenship, an attorney for his family said, in an reckless error.

Discharged to his mother's home the day of the March 9 tooth extraction, Blankenship was found dead in his bed the following morning. According to a civil suit filed earlier this month in King County Superior Court, a medical examiner found Blankenship had died from a drug overdose caused by the fentanyl patch.

"I've already consulted with three experts across the country -- all of them say this is a very egregious case," said Chris Davis, a Seattle attorney with the Davis Law Group representing Blankenship's family. "First, he never should have been given (the fentanyl patch). Second, he was given the highest dose available."

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"We didn't have the system designed to prevent this," said Fisher, adding that the hospital has since conducted a thorough review of how the drug and other painkillers are prescribed.

Fentanyl prescriptions, he said, now require a pain-management specialist's sign off, a safeguard not in place when Blankenship was issued the fatal dose.

"We can never bring back this child, and we can't fully understand to what level we have devastated his family," Fisher said. "We are deeply sorry for the family and will do everything in our power to ensure this never happens to another child at Children's."

According to the Federal Drug Administration, wrong prescription of the fentanyl patch has become a persistent problem across the country during recent years leading to numerous reports of death and life-threatening injuries.

The FDA has been warning since 2005 against misuse of the patch system, which was designed for use only by patients who have developed a tolerance for opium-derived painkillers such as morphine. In a recent public health advisory, the agency warned against prescribing the patch in circumstances identical to those that Blankenship found himself in.

The FDA, according to the statement, "continues to receive reports of death and life-threatening side effects in patients who use the fentanyl patch."

"The reports indicate that doctors have inappropriately prescribed the fentanyl patch to patients for acute pain following surgery, for headaches, occasional or mild pain, and other indications for which a fentanyl patch should not be prescribed," the warning's authors said, according to the FDA Web site.

In Blankenship's case, he was given a patch designed to release 100 micrograms of the drug per hour -- which, Davis asserted, was the maximum dose available. His dentists, according to the allegations, had not previously prescribed the drug to any of their patients.

The patch applied, Blankenship went to bed the night of the surgery. According to court filings, a family member found him unresponsive the following morning; paramedics attempted to revive him to no avail, and he was pronounced dead at the scene.

"I cannot even begin to describe the pain and sorrow that I feel for the death of my dear son," Tammy Jarbo-Blankenship said in a statement. "Michael's needless death has devastated my entire family, and has especially impacted my youngest boy who still refuses to live in our home where Michael was found dead. And knowing how egregious and preventable the mistake was just makes our grief and suffering that much more unbearable."

Following the boy's death, Davis said Jarbo-Blankenship created a foundation in her son's name with the aim of helping autistic children in their lives and the public's understanding of the challenges they face.

Asked whether the dentists or others acted recklessly, Fisher denied the allegation. No one person was responsible for Blankenship's death, Fisher argued, and no punitive action is required.

"There has not been any discipline in this case, nor will there be," said Fisher, speaking at a Tuesday morning news conference. "They care about the consequences. (They're) horrified by what occurred."

"No one along the chain realized that this was not our standard practice," the doctor added.

Concerned that medical malpractice plaintiffs are sometimes viewed as people looking for easy money, Davis said the civil suit was the last chance for Blankenship's family to hold Seattle Children's accountable for the boy's death. One expert, Davis claimed, called it the least defensible case of malpractice he'd seen in 26 years consulting on medical negligence cases.

"I believe the facts are enough here to constitute recklessness," Davis said. "There are no criminal charges. There's no action being taken against the doctor by the hospital. The only thing left is this civil lawsuit filed by his mom.

"Is that enough? I would say no, especially in this type of case when the facts are so egregious."

Attorneys for the hospital have yet to respond formally with the court. That response is expected in coming weeks.